Ablation of atrial fibrillation in patients ≥75 years: long-term clinical outcome and safety
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Ablation of atrial fibrillation in patients ≥75 years: long-term clinical outcome and safety. / Metzner, Ilka; Wissner, Erik; Tilz, Roland R; Rillig, Andreas; Mathew, Shibu; Schmidt, Boris; Chun, Julian; Wohlmuth, Peter; Deiss, Sebastian; Lemes, Christine; Maurer, Tilman; Fink, Thomas; Heeger, Christian; Ouyang, Feifan; Kuck, Karl-Heinz; Metzner, Andreas.
In: EUROPACE, Vol. 18, No. 4, 04.2016, p. 543-9.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Ablation of atrial fibrillation in patients ≥75 years: long-term clinical outcome and safety
AU - Metzner, Ilka
AU - Wissner, Erik
AU - Tilz, Roland R
AU - Rillig, Andreas
AU - Mathew, Shibu
AU - Schmidt, Boris
AU - Chun, Julian
AU - Wohlmuth, Peter
AU - Deiss, Sebastian
AU - Lemes, Christine
AU - Maurer, Tilman
AU - Fink, Thomas
AU - Heeger, Christian
AU - Ouyang, Feifan
AU - Kuck, Karl-Heinz
AU - Metzner, Andreas
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.
PY - 2016/4
Y1 - 2016/4
N2 - AIMS: The prevalence of atrial fibrillation (AF) increases with age. Catheter ablation is an established treatment option for patients with symptomatic AF. We sought to determine the safety and long-term clinical efficacy of AF ablation in patients ≥75 years.METHODS AND RESULTS: Patients ≥75 years with symptomatic, drug-refractory AF were included in the study. Circumferential pulmonary vein isolation (PVI) was performed in all patients, extended to ablation of complex fractionated atrial electrograms, and/or linear lesions in PVI non-responders. Retrospective follow-up (FU) was based on routine outpatient clinic visits and regular telephone interviews. A total of 94 patients (54 male, age 78 ± 2 years, and left atrium diameter 46 ± 6 mm) with drug-refractory AF [55/94 (59%) paroxysmal AF (PAF), 29/94 (31%) persistent AF, and 10/94 (11%) long-standing persistent AF] underwent ablation. Follow-up was obtained in 93/94 (99%) patients. Following a single procedure, 35/93 (38%) patients were in stable sinus rhythm (SR; 46% PAF, 31% persistent AF, and 10% long-standing persistent AF) after a mean FU of 37 ± 20 months. After a mean of 1.5 ± 0.6 procedures, 55/93 (59%) patients were ultimately in stable SR (76% PAF, 41% persistent AF, and 20% long-standing persistent AF). In a total of 137 procedures, 8 major (5.8%) and 26 minor (19%) complications occurred.CONCLUSIONS: Catheter ablation in patients ≥75 years is associated with a favourable clinical long-term outcome in patients with PAF, while results are less promising in persistent or long-standing persistent patients. The safety profile of AF ablation in patients ≥75 years is comparable with patients of younger age.
AB - AIMS: The prevalence of atrial fibrillation (AF) increases with age. Catheter ablation is an established treatment option for patients with symptomatic AF. We sought to determine the safety and long-term clinical efficacy of AF ablation in patients ≥75 years.METHODS AND RESULTS: Patients ≥75 years with symptomatic, drug-refractory AF were included in the study. Circumferential pulmonary vein isolation (PVI) was performed in all patients, extended to ablation of complex fractionated atrial electrograms, and/or linear lesions in PVI non-responders. Retrospective follow-up (FU) was based on routine outpatient clinic visits and regular telephone interviews. A total of 94 patients (54 male, age 78 ± 2 years, and left atrium diameter 46 ± 6 mm) with drug-refractory AF [55/94 (59%) paroxysmal AF (PAF), 29/94 (31%) persistent AF, and 10/94 (11%) long-standing persistent AF] underwent ablation. Follow-up was obtained in 93/94 (99%) patients. Following a single procedure, 35/93 (38%) patients were in stable sinus rhythm (SR; 46% PAF, 31% persistent AF, and 10% long-standing persistent AF) after a mean FU of 37 ± 20 months. After a mean of 1.5 ± 0.6 procedures, 55/93 (59%) patients were ultimately in stable SR (76% PAF, 41% persistent AF, and 20% long-standing persistent AF). In a total of 137 procedures, 8 major (5.8%) and 26 minor (19%) complications occurred.CONCLUSIONS: Catheter ablation in patients ≥75 years is associated with a favourable clinical long-term outcome in patients with PAF, while results are less promising in persistent or long-standing persistent patients. The safety profile of AF ablation in patients ≥75 years is comparable with patients of younger age.
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Anti-Arrhythmia Agents/therapeutic use
KW - Atrial Fibrillation/diagnosis
KW - Catheter Ablation/adverse effects
KW - Drug Resistance
KW - Germany
KW - Humans
KW - Kaplan-Meier Estimate
KW - Male
KW - Pulmonary Veins/physiopathology
KW - Recurrence
KW - Reoperation
KW - Retrospective Studies
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1093/europace/euv229
DO - 10.1093/europace/euv229
M3 - SCORING: Journal article
C2 - 26826139
VL - 18
SP - 543
EP - 549
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 4
ER -